Psychiatric Neurotherapeutics

Description:

This volume covers the gamut of surgical and device-based treatments for psychiatric disorders. Written by experts in the field, this book covers neuroscience advances in the neurobiological underpinnings of psychiatric diseases, emerging surgical and device-based treatments, and advances in the field. Topics include electroconvulsive therapy, transcranial magnetic stimulation, Vagus nerve stimulation (VNS), and many other cutting-edge treatments and techniques. Psychiatric Neurotherapeutics is a valuable resource for psychiatrists, neurosurgeons, neurologists, researchers, and all other medical professionals interested in surgical and device-based treatments of psychiatric disorders.         

Table of Contents:

1: Depression: Current Conceptual Trends

1.1 Introduction

1.2 Genetics of Depression

1.3 Stress and Depression

1.4 Emotion Regulation

1.5 Functional Neuroanatomy of Depression

1.6 The Anterior versus Lateral Network: Two Complementary Modes

1.7 The Impasse in Mood Disorder Research: The Need for a Paradigm Shift

1.8 Current Paradigm and Its Limitations

1.9 Possible Options for the Future

1.10 Final Discussion

References

2: Obsessive-Compulsive Disorder

2.1 Clinical Features

2.1.1 Prevalence

2.1.2 Age of Onset

2.1.3 Gender

2.1.4 Race and Cultural Factors

2.1.5 Risk Factors

2.1.6 Genetic Factors

2.2 Assessment

2.3 Treatment Algorithms

2.3.1 Prognosis

2.4 Clinician/Consumer Resources

References

3: Neuroimaging and Neurocircuitry of Obsessive-Compulsive Disorder and Major Depressive Disorder

3.1 Introduction

3.2 Obsessive-Compulsive Disorder

3.2.1 Background

3.2.2 Functional Anatomy

3.2.3 Cortico-Striato-Thalamo-Cortical Pathways

3.2.4 The Corticostriatal Hypothesis of OCD

3.2.5 Structural Imaging in OCD

3.2.6 Recent Developments in OCD Neurocircuitry

3.2.7 Conclusions

3.3 Major Depressive Disorder

3.3.1 Background

3.3.2 The Neural Substrates of Mood Disorders

3.3.3 Limbic Structures

3.3.4 Prefrontal Cortex

3.3.4.1 Orbital and Medial Prefrontal Cortex

3.3.4.2 Orbital Prefrontal Network

3.3.4.3 Medial Prefrontal Network

3.3.4.4 Lateral Prefrontal Cortex

3.3.5 Cortico-Striato-Thalamo-Cortical Pathways

3.3.6 Clinical Evidence from Studies of Mood Disorders

3.3.6.1 Limbic System

3.3.6.2 Prefrontal Cortex

3.3.6.3 Other Subcortical Structures

3.3.7 Conclusions

References

4: Electroconvulsive Therapy

4.1 Indications

4.2 Predictors of Response

4.3 Contraindications

4.4 Adverse Effects

4.5 Maintenance ECT

4.6 Mechanisms of Action of ECT

4.7 Clinical Application of ECT

4.7.1 ECT Technique

4.7.2 Interaction with Medications

4.7.3 Informed Consent

4.7.4 New Directions

4.8 Summary

References

5: Vagus Nerve Stimulation (VNS)

5.1 Introduction

5.2 History and Evidence

5.2.1 Mood Changes in Epilepsy Studies

5.2.2 Open-Label Studies in TRD

5.2.3 Results from the RCT of VNS in TRD

5.2.4 Longer-Term Outcomes with VNS versus Treatment as Usual

5.2.5 FDA Approval of VNS for TRD

5.3 VNS Basics

5.3.1 Vagus Nerve Anatomy

5.3.2 Mechanism of Action in Depression

5.3.3 VNS Device Surgery

5.4 Managing Patients with VNS in the Office

5.4.1 VNS Device Programming

5.4.1.1 Candidates for Therapy

5.4.1.2 General Precautions and Contraindications

5.4.2 Dosing Parameters

5.5 VNS Effectiveness in Clinical Practice Post: FDA Approval

5.6 Safety and Tolerability

5.6.1 Surgery Complications

5.6.2 Side Effects Related to Stimulation

5.6.3 Psychiatric Adverse Events

5.6.4 Adherence to Treatment

5.7 Summary

References

6: Neurosurgical Ablative Procedures for Psychiatric Disorders

6.1 Introduction

6.2 Historical Perspective

6.3 Neurocircuitry of MDD/OCD

6.4 General Caveats of the Literature

6.5 Anterior Cingulotomy

6.5.1 Efficacy of Anterior Cingulotomy

6.5.2 Adverse Effects of Anterior Cingulotomy

6.6 Anterior Capsulotomy

6.6.1 Efficacy of Anterior Capsulotomy

6.6.2 Adverse Effects of Anterior Capsulotomy

6.7 Subcaudate Tractotomy

6.7.1 Efficacy of Subcaudate Tractotomy

6.7.2 Adverse Effects of Subcaudate Tractotomy

6.8 Limbic Leucotomy

6.8.1 Efficacy of Limbic Leucotomy

6.8.2 Adverse Effects of Limbic Leucotomy

6.9 Mechanism of Action

6.10 Future Directions

References

7: Deep Brain Stimulation for Obsessive-Compulsive Disorder and Major Depressive Disorder

7.1 Introduction

7.2 History of Deep Brain Stimulation

7.3 Scientific Context

7.4 Procedures and Practices

7.5 Neuromodulation

7.6 Deep Brain Stimulation of OCD Patients and Circuits

7.6.1 Clinical Outcomes

7.7 Deep Brain Stimulation of MDD Patients and Circuits

7.7.1 Clinical Outcomes

7.8 Cognition

7.9 Neuroimaging

7.10 Conclusion and Future Directions

References

8: Transcranial Magnetic Stimulation

8.1 Introduction

8.2 TMS Principles

8.3 TMS Parameters

8.4 TMS Safety

8.5 TMS Clinical Applications: Major Depressive Disorder

8.5.1 Pivotal Trial

8.5.2 Naturalistic Studies

8.5.3 Durability and Maintenance

8.5.4 Predictors of Response

8.5.5 H-Coil Deep TMS

8.6 Summary

References

9: Ablative Neurotherapeutics and Deep Brain Stimulation in Animal Models of Psychiatric Disorder

9.1 Introduction

9.2 PD: A Psychiatric Disorder? Non-motor Symptoms and Lesions or DBS

9.2.1 Globus Pallidus Interna/Entopeduncular Nucleus

9.2.2 Subthalamic Nucleus

9.2.2.1 Subthalamic Nucleus Lesions

9.2.2.2 Subthalamic Nucleus DBS

9.3 OCD: Impulse Control Disorder

9.3.1 Repeated Behavior as an Index of Compulsion

9.3.1.1 Nucleus Accumbens Manipulations on Various Forms of Repeated Behavior

9.3.1.2 Subthalamic Nucleus Manipulations on Various Forms of Repeated Behavior

9.3.2 Control of Inhibition

9.3.2.1 Nucleus Accumbens

9.3.2.2 Subthalamic Nucleus

9.4 Anxiety-Depression

9.5 Addiction

9.5.1 Nucleus Accumbens

9.5.2 Lateral Habenula, Lateral Hypothalamus, and Prefrontal Cortex

9.5.3 STN

9.5.3.1 STN: A Possible Target

9.5.3.2 STN DBS: The Possible Strategy

9.6 Conclusion

References

10: Future of Neurosurgery

10.1 Introduction

10.2 Understanding Circuits

10.3 Modes of Delivery

10.4 Future Applications

10.5 Conclusions

References

Index

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